Mobile Lymphedema Clinic Llc

LBN: Mobile Lymphedema Clinic Llc
Mobile Lymphedema Clinic Llc is an health care organization with primary practice located at 804 Pine Alley St , Fort Walton Beach FL 32547-1216. The organization recently has 7 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Environmental Modification, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Ergonomics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Gerontology, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is the primary health care specialty. Mobile Lymphedema Clinic Llc can be contacted via phone (850) 803-6683, or through Boothe, Jessica Colleen via phone (850) 217-2186.

Contact Information

Primary practice address
804 Pine Alley St Fort Walton Beach FL 32547-1216
Phone: (850) 803-6683
Fax: (888) 857-4412
Website:
Map and Directions
Authorized official contact:
Name: Boothe, Jessica Colleen MSOT, OTR/L, CLT
Phone: (850) 217-2186

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Environmental Modification 225XE0001X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Ergonomics 225XE1200X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Gerontology 225XG0600X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand 225XH1200X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation 225XP0019X

Profile Details

NPI number 1104706837
LBN Legal business name Mobile Lymphedema Clinic Llc
DBA Doing business as
Authorized official Boothe, Jessica Colleen MSOT, OTR/L, CLT
Entity Organization
Organization subpart 1 No
Enumeration date Sep 4th, 2025
Last updated Feb 18th, 2026 - about 8 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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